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Agent:
Kevin Coughlin
File Date:
1/28/2011
Confirmation:
20110128LINA35198
I. Engagement Date:
2/1/2011
Employer Information:
Name:
Ohio State Dental Board
Real Party In Interest:
Type of industry:
State Agency
Address:
77 S High St, 17th Fl
Address 2:
City:
Columbus
State:
OH
Zip Code:
43215
Contact Person:
Lili C. Reitz
Phone:
(614) 466-2580
E-Mail:
dental.board@den.state.oh.us
III. Brief description of the type of legislation to which the Legislative Agent's engagement relates:
Any legislation impacting the operation of the Dental Board
IV. Categorical listing of principal business or activity of Employer:
-Public Interest
-State Government
V. I am a state employee/officer registering on behalf of my public agency, other than an institution of higher education:
NOT CHECKED